Helicobacter pylori eradication – the most common mistakes

Choosing the optimal eradication therapy for Helicobacter pylori is a frequent challenge faced by general practitioners. The increasing resistance of bacteria to some antibiotics observed in recent years, and thus the reduced effectiveness of treatment, is a growing problem. For this reason, standard triple therapy (proton pump inhibitor, amoxicillin, and clarithromycin) should not be used as the first-choice treatment in Poland. According to current guidelines, a quadruple therapy regimen with or without bismuth for 10-14 days should be implemented in the eradication therapy of H. pylori. In the case of treatment failure, triple therapy with levofloxacin or quadruple therapy with bismuth (if not previously used) should be used in the second-line therapy. The article presents the most common mistakes that are made by physicians and patients during H. pylori eradication therapy. These include non-compliance with the current guidelines regarding the choice of treatment regimen, the repeated use of antibiotics that were ineffective previously, too short duration of therapy, inadequate inhibition of gastric acid secretion, non-compliance with medical recommendations, failure to assess the effectiveness of therapy, and lack or inadequate use of probiotics during eradication. In light of new reports, the administration of certain probiotics such as Saccharomyces boulardii or Lactobacillus reuteri increases the effectiveness of treatment and reduces the frequency of adverse effects of antibiotic therapy.